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FORM NO. 12BB

(See rule 26C)
FLIPKART GROUP
Statement showing particulars of claims by an employee for deduction of tax under section 192
For the period 01/04/2023 to 31/03/2024 ( A.Y.: 2024-2025)

Emp No : 153911 Name : Varun Sharma

Emp. PAN : DXWPS0356F Address :
Selected
Old
Regime :

Details of claims and evidence thereof

1 House Rent Allowance

Name of the Address of Rent PAN of Landlord Period of Lease (2nd / City -
Landlord the Amount *mandatory, if 3rd block to be filled Rented
Landlord per rent>Rs.8,333 /-p.m. only if there Place
month is any change in place
/ rent
during the year)
Landlord Tilak Landlord
FYZPR5779B
Name Raj PAN1
Landlord Landlord
Hno. 509 From
Name PAN2 01/04/2023
Sector 10A 22000 : Others
Landlord Gurgaon Landlord
Upto : 31/03/2024
Name PAN3
Landlord Landlord
Name PAN4
Landlord Landlord
Name PAN1
Landlord Landlord
Name PAN2 From :
Landlord Landlord Upto :
Name PAN3
Landlord Landlord
Name PAN4
Landlord Landlord
Name PAN1
Landlord Landlord
Name PAN2 From :
Landlord Landlord Upto :
Name PAN3
Landlord Landlord
Name PAN4
Landlord Landlord From :
Name PAN1 Upto :

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Landlord Landlord
Name PAN2
Landlord Landlord
Name PAN3
Landlord Landlord
Name PAN4
2 Leave Travel Concession or assistance (separate form
attached)

3 Deduction of interest on borrowing

A. Interest on Housing Loan (Loss on Self-occupied House Property [u/s
24(b)])
Whether possession Date of Possession Taken:
taken:
Name of Lender PAN of Lender
Address of the Lender
B. Interest On Housing Loan (Loss On 2nd Self-Occupied House Property)
[u/s 24(2)] (LOHA)
Whether possession Date of Possession Taken:
taken:
Name of Lender PAN of Lender
Address of the Lender

C. Interest on Housing Loan taken after 1st April, 2016 for self occupied
property [u/s 80EE]
Date of Loan disbursal: Name of Lender:

D. Interest On Housing Loan taken after 1st April, 2019 [u/s 80EEA]
Date of Loan disbursal: Name of Lender:

E. Interest On Electric Vehicle Loan taken after 1st April, 2019 [u/s 80EEB]
Date of Loan disbursal: Name of Lender:
Registration Number of
Electric Vehicle Model
Vehicle

F.Let out / Deemed let out property (Income/Loss on housing Property)[u/s 24(2)]

(c) (d)
<(a)-
(a) Annual (b) Interest Standard
Sr. (b)- Name of PAN of
Rent Municipal on Deduction
No. (d)- Lender Lender
receivable: Taxes: Housing Repairs @
(c)
Loan: 30%
1
2
3
4
I undertake that Interest on Housing Loan as claimed above is in respect of House property,for which construction has been
completed and the possession has already been taken by me OR is due to be taken in the current financial year.

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4 A Deduction under chapter VIA- Sec 80C, 80CCC, 80CCD Amount(Rs.) PROOF CODE

80C - LIP
1 Payment of Life Insurance Premium (For self, spouse & 30000 LIP
children)
80C - ELSS
2 Contribution to Equity Linked Savings Scheme - TAX SAVER- 20000 ELSS
MF (Self)
80C - FD
3 Fixed Deposit for 5 years with a Scheduled Bank (Tax Saver - 60000 FD
Self)
80CCD(1B) - NPS
4 50000 NPS
National Pension Scheme (upto Rs. 50000/-)
80DD - SEC80DD
5 Medical treatment of handicapped dependent (Dependents) – 0
Rs.75000/Rs.125000/-
80CCC - PENSION
6 0
Contribution to Pension Plans (Self)
80C - HLP
7 Housing Loan Principal (Amount will auto populate after 0
updating “Loss from House Property” Section)
80C - STAMP_DUTY
8 Stamp Duty/Registration charges paid for new House 0
Property
80C - PPF
9 Deposit in Public Provident Fund-PPF (For self, spouse & 0
children)
80U - SEC80U
10 Deduction in case of self being totally blind or physically 0
handicapped- Rs.75000/Rs.125000/-
80C - NSC
11 0
Purchase of National Savings Certificate (Self)
80C - FEES
12 Payment of tuition fees for children to any School, College, 0
University or Educational Institution (Self)
80C - SUKANYA
13 0
Sukanya Samriddhi Scheme (For Girl child)
80D - SEC80D
Mediclaim Policy Premium (For Self, spouse, children)-Below
14 0
60 years -Rs 25000/- (Including amount paid for Preventive
health check-up Rs.5000/-)
80DP - SEC80DP
Mediclaim Policy Premium (For Dependent Parents)-Below 60
15 0
years -Rs 25000/- (Including amount paid for Preventive
health check-up Rs.5000/-)
80C - ULIP
16 Contribution to Unit Linked Insurance Plan (For self, spouse & 0
children)
80DS - SEC80DS
Mediclaim Policy Premium (For Self, spouse, children)-Above
17 0
60 years -Rs 50000/- (Including amount paid for Preventive
health check-up Rs.5000/-)
80DDB - SEC80DDB
Treatment of specified diseases for self/dependents -Below 60
18 0
years – Actual Expenditure upto Rs. 40000/- reduced by
insurance claims

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80E - SEC80E
19 Payment of interest on loan taken for higher education for a 0
full time course -Without any limit (Self/Spouse/Children)
80DDBS - SEC80DDBS
20
Treatment of specified diseases for self/dependents -Above 0
60 years – Actual Expenditure upto Rs. 100000/- reduced by
insurance claims
80EEB - SEC80EEB
21 Interest On Loan taken for purchase of Electric Vehicle (upto 0
Rs.150000/-)
80DPS - SEC80DPS
22
Mediclaim Policy Premium ( For Dependent Parents) Above 60 0
years- Rs. 50,000 (Including amount paid for Preventive
Health Check- up- Rs.5000)

5 Income from any previous employer in the current year 2023-2024

(a) Net Salary Income (c) Provident Fund recovered
(b) Profession Tax
(d) Income Tax recovered
deducted

Declaration:
I hereby confirm that I have invested/contributed the above amounts for the purpose of rebate/deduction to be considered in calculating my income tax
for the F.Y. 2023-2024. I further undertake that wherever eligible investments are made in the name of spouse/children/dependent parents, the same
have been made out of my income and claim thereof shall not be made elsewhere to get Income Tax benefit. I will produce the tenancy / lease
agreement in respect of rents paid, or any other supporting documentation requested by the Company, in support of my claim.I hereby declare that all
the information given by me is true and correct and I undertake to notify you immediately of any change in the above facts.I also confirm my
understanding that I may be subject to disciplinary action ,up to and including termination of my employment, for any false or tampered submission. Any
Income Tax and I undertake to indemnify the Company and its officers from all consequences, monetary and otherwise, arising out of any incorrect
and/or incomplete information provided in this declaration.

Emp Signature:
Place : 153911
ID :
15/09/2023 05:20
Dated : Name
PM Varun Sharma
:
Last
Updated 15/09/2023 05:20:32 PM
Date :

Note: Employee's contribution towards PF, VPF, Mediclaim, Insurance deduction in payroll will get automatically
considered for exemption u/s 80.

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